Filipino Nurses' Experiences in a Collaborative Advanced Practice Model: A Critical Incidents Study

The advanced practice nursing role has been found to be a potential solution in low and middle-income countries where access to primary care physicians is limited. In the Philippines, this advanced role has yet to be enacted, hindering the full potential of nurses as primary care providers. Hence, this study aimed to provide an in-depth analysis of nurses' experiences within a collaborative advanced practice model for hypertension care in the Philippines. This qualitative study utilized a modified version of the Critical Incident Technique. Three participating nurses were asked to self-report the behaviors, interactions, and emotions that positively or negatively impacted their clinic experiences. Similarities in the data were iteratively labeled and classified until major themes emerged. Findings indicate that the overarching theme underpinning the nurses' experiences in a collaborative advanced practice model was the significant role transition they underwent. While undergoing this transition, three distinct sub-themes of critical incidents emerged: 1) acquiring and maintaining competence, 2) establishing and strengthening collaboration, and 3) gaining and maintaining trust or respect. These insights on the successful role transition of advanced practice nurses in a primary care seting should be used by low-and middle-income countries when establishing their advanced practice nursing frameworks. Furthermore, training programs that prepare advanced practice nurses should also tailor their curricula and strategies on the relevant competencies to include collaboration skills towards building trust with patients and other healthcare providers.